扩张型心肌病心衰与低钠血症的关系探讨

目的　探讨低钠血症与扩张型心肌病心衰之间存在的内在联系及其对预后的影响。方法　选取扩张型心肌病合并心衰患者 68例 ,分别测定血电解质 (钾、钠、氯 )、血糖、肾功能及计算血浆渗透压。比较正常血钠组和低血钠组的死亡率 ,同时比较低血钠组中不同心功能级别血钠值和死亡率的差异。结果　 68例中正常血钠 2 0例 (占2 9.4 % ) ,低血钠 4 8例 ( 70 .6% ) ,低血钠组死亡率明显高于正常血钠组 ( P<0 .0 5 ) ;低血钠组中 ,心功能 级组血钠值明显低于心功能 、 级组 ( P<0 .0 1 ) ,且死亡率明显增高 ( P<0 .0 5 )。结论　扩张型心肌病合并心衰患者 ,低钠血症发生率较高 ,一旦发生低钠血症、低渗性脑病 ,死亡率明显增高

To explore the relation of hyponatremia and heart failure in dilated cardiomyopathy

Objective To explore the relationship between hypontremia and heart failure in dilated cardiomyopathy(DCM) and assess the affect of hyponatremia on DCM prognosis.Methods 68 patients with heart failure stage of DCM were measured the level of blood natrium,blood sugar and kidney function.The plasma osmotic pressure was calculated.All patients were divided into normal and hyponatremia groups.The difference of mortality between two groups was compared.The relationship of serum natrium level and mortality in hyponatremia patients with variant heart function stage was disscussed.Results There were 20 cases with normal blood natrium level and 48 with hyponatremia.The mortality of hypontremia group was significantaly higher than that of normal blood natrium level group(P<0.05).In hyponatremia group,the level of serum natrium was obviously lower in patients with NYHA heart function class IV than that in class II and III(P<0 01).On the other hand,the mortality was significantly higher in the patients class IV than that in class II and III(P<0 05).Conclusion The incidence of hyponatremia is higher in DCM with heart failure.Once hyponatremia occurred,the possibility of died from hypotonic encephal opathy would increase markedly.